Comparing the Time of Passage of the First Meconium (PoFM) in Neonates With and Without Hirschsprung’s Disease (HD)

Objective: To compare the age at “passage of the first meconium” (PoFM) in neonates with and without Hirschsprung’s disease (HD) and determine the optimal cut-off age for predicting HD. Materials and Methods: A retrospective investigation was conducted on selected neonates at Siriraj Hospital, including those with HD, between January 2000 and December 2022. Results: The study included 800 neonates, including 38 with HD and 762 non-HD. At 24 hours, 3.0% of non-HD and 10.5% of HD had delayed PoFM, a statistically significant difference (p=0.035). Despite the common perception that the risk of HD increases if neonates did not pass their first meconium within the first 24 hours, 89.5% of HD patients pass their first meconium in less than a day. The median ages of PoFM were 10.5 hours for HD and 8.0 hours for non-HD, respectively, with no statistically significant difference between the groups (p=0.289). A receiver operating characteristic (ROC) curve and area under the ROC (AUC) were used to determine the optimal cut-off value of PoFM age (hour) for predicting HD. The AUC for PoFM age, in hour, was 0.551, and the optimal cut-off value could not be determined. Prenatal MgSO₄ or steroid therapy did not affect the age of PoFM (p=0.966 and 0.452, respectively). Conclusion: Eighty-nine-point-five percent of HD patients passed their first meconium within 24 hours. The PoFM was similar for both HD and non-HD groups.